CramX Logo
RegisterLog in
2023 HESI RN Pediatrics Exit Exam Test Bank With Answers (490 Solved Questions) - Document preview page 1

2023 HESI RN Pediatrics Exit Exam Test Bank With Answers (490 Solved Questions) - Page 1

Document preview content for 2023 HESI RN Pediatrics Exit Exam Test Bank With Answers (490 Solved Questions)

2023 HESI RN Pediatrics Exit Exam Test Bank With Answers (490 Solved Questions)

2023 HESI RN Pediatrics Exit Exam Test Bank With Answers provides structured past exams to support your study routine.

Ella Hall
Contributor
4.2
0
12 months ago
Preview (16 of 216 Pages)
100%
Log in to unlock
Page 1 of 16
2023 HESI RN Pediatrics Exit Exam Test Bank With Answers (490 Solved Questions) - Page 1 preview imageHESI RN EXIT 2023 EXAM TEST BANK 780+ACTUAL WRITTEN QUESTIONS AND ANSWERSWITHRATIONALEBased on the information provided in this client's medical record during labor, whichshouldthenurseimplement?(Clickoneachcharttabforadditionalinformation.Pleasebe sure to scroll to the bottom right corner of each tab to view all information containedintheclient'smedical record.)a.Applyoxygen 10l/maskb.Stoptheoxytocininfusionc.Turntheclienttotherightlateralposition.d.Continuetomonitortheprogressoflabor.-Continuetomonitorthe progressoflaborRationale:Earlydecelerationareindicativeofheadcompressionasthefetusdescendsin the birth canal, which is a normal patter during active labor, so labor progressionshouldcontinuetobemonitoredFollowing discharge teaching, a male client with duodenal ulcer tells the nurse the hewilldrinkplentyofdairyproducts,suchasmilk,tohelpcoatandprotecthisulcer.Whatisthebestfollow-upaction bythe nurse?a.Remindtheclientthatitisalsoimportanttoswitchtodecaffeinatedcoffeeandtea.b. Suggest that the client also plan to eat frequent small meals to reduce discomfortc.Reviewwiththeclientthe needtoavoidfoodsthatare richinmilk andcream.d. Reinforce this teaching by asking the client to list a dairy food that he might select.-Reviewwith theclienttheneedtoavoidfoodsthatare richin milkand creamRationale:Dietsrichinmilkandcreamstimulategastricacidsecretionandshouldbeavoided.A male client with hypertension, who received new antihypertensive prescriptions at hislastvisitreturnstotheclinictwoweeks latertoevaluatehis bloodpressure(BP).HisBPis 158/106 and he admits that he has not been taking the prescribed medicationbecause the drugs make him "feel bad". In explaining the need for hypertension control,the nurse should stress that an elevated BP places the client at risk for whichpathophysiologicalcondition?a.Blindnesssecondarytocataractsb.Acutekidneyinjuryduetoglomerulardamagec.Strokesecondarytohemorrhage
Page 2 of 16
2023 HESI RN Pediatrics Exit Exam Test Bank With Answers (490 Solved Questions) - Page 2 preview image
Page 3 of 16
2023 HESI RN Pediatrics Exit Exam Test Bank With Answers (490 Solved Questions) - Page 3 preview imaged.Heartblockduetomyocardialdamage-StrokesecondarytohemorrhageRationale:Strokerelatedtocerebralhemorrhageismajorriskforuncontrolledhypertension.The nurse observes an unlicensed assistive personnel (UAP) positioning a newlyadmittedclientwhohasa seizuredisorder.TheclientissupineandtheUAPisplacingsoftpillowsalongtheside rails. Whataction shouldthenurseimplement?a.EnsurethattheUAPhasplacedthepillowseffectivelytoprotecttheclient.b.Instruct the UAP to obtain soft blankets to secure to the side rails instead of pillows.c.AssumeresponsibilityforplacingthepillowswhiletheUAPcompletesanothertask.d. Ask the UAP to use some of the pillows to prop the client in a side lying position.-InstructtheUAPtoobtainsoftblanketsto securetothesiderailsinsteadofpillowsRationale: The nurse should instruct the UAP to pad the side rails with soft blankestbecausetheuseofpillowscouldresultinsuffocationandwouldneedtoberemovedattheonsetoftheseizure.ThenursecandelegatepaddlingthesiderailstotheUAPAn adolescent with major depressive disorder has been taking duloxetine (Cymbalta) forthepast12days.Which assessmentfinding requiresimmediatefollow-upa.Describeslifewithoutpurposeb.Complainsofnauseaandlossofappetitec.Statesis oftenfatigued anddrowsyd.Exhibitsanincreaseinsweating.-DescribeslifewithoutpurposeRationale:Cymbaltaisaselectiveserotoninandnorepinephrinereuptakeinhibitorthatis known to increase the risk of suicidal thinking in adolescents and young adults withmajordepressive disorder. B,C and D areside effectsA 60-year-old female client with a positive family history of ovarian cancer hasdevelopedanabdominalmassandisbeingevaluatedforpossibleovariancancer.HerPapanicolau (Pap) smear results are negative. What information should the nurseincludeinthe client'steaching plana.Furtherevaluationinvolvingsurgerymaybeneededb.Apelvicexamisalsoneededbeforecancerisruled outc.Papsmearevaluationshouldbecontinuedeverysixmonthd.One additional negative pap smear in six months is needed.-Further evaluationinvolvingsurgerymaybe neededRationale:Anabdominalmassinaclientwithafamilyhistoryforovariancancershouldbeevaluated carefully
Page 4 of 16
2023 HESI RN Pediatrics Exit Exam Test Bank With Answers (490 Solved Questions) - Page 4 preview imageA client who recently underwent a tracheostomy is being prepared for discharge tohome.Whichinstructionsismostimportantforthenursetoincludeinthedischargeplan?a.Explainhowtousecommunicationtools.b.Teachtrachealsuctioningtechniquesc.Encourageself-careandindependence.d.Demonstratehowtocleantracheostomysite.-TeachtrachealsuctioningtechniquesRationale:Suctioninghelpstoclearsecretionsandmaintainanopenairway,whichiscritical.In assessing an adult client with a partial rebreather mask, the nurse notes that theoxygenreservoirbagdoesnotdeflatecompletelyduringinspirationandtheclient'srespiratoryrateis14breaths/minute.Whatactionshouldthenurseimplementa. Encourage the client to take deep breathsb.Removethemaskto deflatethe bagc.Increasetheliterflowofoxygend.Documenttheassessmentdata-DocumenttheassessmentdataRational:reservoirbagshouldnotdeflatecompletelyduringinspirationandtheclient'srespiratoryrateis within normal limits.Duringshiftreport,thecentralelectrocardiogram(EKG)monitoringsystemalarms.Whichclient alarm shouldthe nurse investigate first?a. Respiratory apnea of 30 secondsb.Oxygensaturationrateof88%c.Eightprematureventricularbeatseveryminuted. Disconnected monitor signal for the last 6 minutes.-Respiratory apnea of 30secondsRationale:Thepriorityistheclientwhosealarmindicatingrespiratoryapneathatshouldbeassessedfirst.Duringahomevisit,thenurseobservedanelderlyclientwithdiabetesslipandfall.Whataction shouldthenurse takefirst?a.Givetheclient4 ouncesoforange juiceb.Call 911 to summon emergency assistancec.Checktheclientforlacerationsorfracturesd.Assesclientsbloodsugar level-ChecktheclientforlacerationsorfracturesRationale:Aftertheclientfalls,thenurseshouldimmediatelyassessforthepossibilityofinjuriesandprovidefirst aid asneeded
Page 5 of 16
2023 HESI RN Pediatrics Exit Exam Test Bank With Answers (490 Solved Questions) - Page 5 preview imageAt 0600 while admitting a woman for a schedule repeat cesarean section (C-Section),theclienttellsthenursethatshedrankacupacoffeeat0400becauseshewantedtoavoidgetting aheadache.Whichaction shouldthenurse takefirst?a.Ensurepreoperativelabresultsareavailableb.StartprescribedIVwith lactatedRinger'sc.Informtheanesthesiacareproviderd.Contacttheclient'sobstetrician.-Inform theanesthesiacareproviderRationale: Surgical preoperative instruction includes NPO after midnight the day ofsurgery to decrease the risk of aspiration should vomiting occur during anesthesia.WhileitispossibletheC-sectionwillbedoneonscheduleorrescheduledforlaterintheday,theanesthesia provider shouldbenotifiedfirst.Afterplacingastethoscopeasseeninthepicture, thenurseauscultatesS1andS2heart sounds. To determine if an S3 heart sound is present, what action should thenursetake firsta. Side the stethoscope across the sternum.b.Movethestethoscope tothemitral sitec.Listenwiththebellatthesamelocationd.Observethecardiactelemetrymonitor-ListenwiththebellatthesamelocationRationale: The nurse uses the bell of the stethoscope to hear low-pitched sounds suchas S3 and S4. The nurse listens at the same site using the diaphragm the diaphragmandbellbeforemovingsystematically to the nextsites.A66-year-oldwomanisretiringandwillnolongerhaveahealthinsurancethroughherplace of employment. Which agency should the client be referred to by the employeehealthnurse forhealthinsuranceneeds?a.Woman,Infant,andChildrenprogramb.Medicaidc.Medicared.ConsolidatedOmnibusBudgetReconciliationActprovision.-MedicareRationale: Title XVII of the social security Act of 1965 created Medicare Program toprovide medical insurance for person more than 65 years or older, disable or withpermeant kidney failure, WIC provides supplemental nutrition to meet the needs ofpregnant of breastfeeding woman, infants and children up to age of 6. Medicaidprovides financial assistance to pay for medical services for poor older adults, blind,disableandfamilieswith dependentchildren.COBRA(D)healthbenefitprovisionsisalimitedinsuranceplanforthosewhohasbeenlaidofforbecomeunemployed.
Page 6 of 16
2023 HESI RN Pediatrics Exit Exam Test Bank With Answers (490 Solved Questions) - Page 6 preview imageAclientwhoistakinganoraldoseofatetracyclinecomplainsofgastrointestinalupset.Whatsnackshould thenurse instructthe clienttotakewith thetetracycline?a. Fruit-flavored yogurt.b.Cheeseandcrackers.c.Coldcerealwith skimmilk.d.Toastedwheatbreadandjelly-ToastedwheatbreadandjellyRationale: Dairy products decrease the effect of tetracycline, so the nurse instructs theclienttoeatasnacksuchastoast,whichcontainsnodairyproductsandmaydecreaseGI symptoms.Followingalumbarpuncture,aclientvoicesseveralcomplaints.Whatcomplaintindicatedtothe nursethatthe clientisexperiencingacomplication?a."Iamhavingpaininmy lowerback whenImovemylegs"b."My throathurtswhen Iswallow"c."Ifeelsicktomy stomachand amgoing tothrow up"d. I have a headache that gets worse when I sit up"-"I have a headache that getsworse whenI situp"Rationale:Apost-lumbarpunctureheadache,rangingfrommildtosevere,mayoccuras a result of leakage of cerebrospinal fluid at the puncture site. This complication isusuallymanaged bybedrest,analgesic,andhydration.Anelderlyclientseemsconfusedandreportstheonsetofnausea,dysuria,andurgencywith incontinence.Whichaction shouldthenurse implementa.Auscultateforrenalbruitsb.Obtain a clean catch mid-stream specimenc.Useadipsticktomeasureforurinaryketoned.Begintostraintheclient'surine.-Obtainacleancatchmid-streamspecimenRationale: This elderly is experiencing symptoms of urinary tract infection. The nurseshouldobtainacleancatchmid-streamspecimentodeterminethecausativeagentsoananti-infective agentcan be prescribed.The nurse is assisting the mother of a child with phenylketonuria (PKU) to select foodsthatarein keepingwiththechild'sdietaryrestrictions.Whichfoodsarecontraindicatedforthis child?a.Wheatproductsb.Foodssweetenedwithaspartame.c.High fat foodsd.Highcaloriesfoods.-Foodssweetenedwithaspartame
Page 7 of 16
2023 HESI RN Pediatrics Exit Exam Test Bank With Answers (490 Solved Questions) - Page 7 preview imageRationale:AspartameshouldnotbeconsumedbyachildwithPKUbecauseutisconverted to phenylalanine in the body. Additionally, milk and milk products arecontraindicatedfor childrenwithPKU.Before preparing a client for the first surgical case of the day, a part-time scrub nurseasksthecirculatingnurseifa3minutesurgicalhandscrubisadequatepreparationforthisclient.Whichresponse should thecirculating nurseprovide?a. Ask a more experience nurse to perform that scrub since it is the first time of the dayb.Validatethe nurseisimplementingthe ORpolicy forsurgical handscrubc.Informthenursethathandscrubsshouldbe3minutesbetweencases.d. Direct the nurse to continue the surgical hand scrub for a 5-minute duration.-Directthenurse tocontinue the surgicalhand scrubfor a5minute durationRationale:Thesurgicalhandscrubshouldlastfor5to10mints,sothenurseshouldbedirected to continue the vigorous scrub using a reliable agent for the total duration of 5mints. It is not necessary to reassign staff (A). The length of the hand scrub andsubsequent scrubs during the day require the same process for the same amount oftime, (Band C)Which breakfast selection indicates that the client understands the nurse's instructionsaboutthedietarymanagementofosteoporosis?a.Eggwhites,toastandcoffee.b.Branmuffin,mixedfruits,andorangejuice.c.Granola andgrapefruit juiced.Bagelwithjellyandskim milk.-Bagelwithjelly andskimmilkRationale: D includes dairy products which contain calcium and does not include anyfoods that inhibit calcium absorption. The primary dietary implication of osteoporosis isthe need for increased calcium and reduction in foods that decrease calcium absorption,suchascaffeineand excessive fiber.The charge nurse of critical care unitinformed at beginning of shift that less thanoptimalnumberregisterednursesbeworkingthatshift.Inplanningassignments,whichclientshould receivemost carehours byaregisterednursea.A34yoadmittedtodayafteremergencyappendendectomywhohasperipheralintravenouscatheter, Foley catheter.b.A48yomarathonrunnerw/acentralvenouscatheterexperiencingnausea,vomitingduetoelectrolytedisturbancefollowingarace.c.A 63 yo chain smoker w/ chronic bronchitis receiving O2 nasal cannula and a saline-lockedperipheral intravenous catheter.d.An 82 yo client with Alzheimer's disease newly-fractures femur w/Foley catheter andsoft wrist restrains applied-An 82-year-old client with Alzheimer's disease newly-fracturesfemur whohas aFoleycatheterandsoftwrist restrainsapplied
Page 8 of 16
2023 HESI RN Pediatrics Exit Exam Test Bank With Answers (490 Solved Questions) - Page 8 preview imageRationale: (D) describe the client at the most risk for injury and complications becauseof the factor listed. (A) has complete the recovery period form anesthesia but requirescriticalcarebecauseoftheinvasivelinesandnewabdominalincision.(B)islikelytobein excellent physical condition and has one invasive line needed for rehydration. (C) isessentiallystable, despite havinga chronic condition.A mother brings her 6-year-old child, who has just stepped on a rusty nail, to thepediatrician'soffice.Uponinspection,thenursenotesthatthenailwentthroughtheshoe and pierced the bottom of the child's foot. Which action should the nurseimplementfirst?a.Cleansethefootwithsoapandwaterandapplyanantibioticointmentb.Provideteachingabouttheneedforatetanusboosterwithinthenext72hours.c.havethemothercheckthechild's temperatureq4hforthenext24hoursd.transferthechildtotheemergencydepartmenttoreceiveagammaglobulininjection-CleansethefootwithsoapandwaterandapplyanantibioticointmentRationale:ThenurseshouldcleansethewoundfirstandimplementBnext.Themotherofanadolescenttellstheclinicnurse,"Mysonhasathlete'sfoot,Ihavebeen applying triple antibiotic ointment for two days, but there has been noimprovement."Whatinstructionshould the nurseprovide?a.Antibioticstaketwoweekstobecomeeffectiveagainstinfectionssuchasathlete'sfoot.b.Continueusingtheointmentforafullweek,evenafterthesymptomsdisappear.c.Applyingtoomuchointmentcandeteritseffectiveness.Applyathinlayertopreventmaceration.d.Stop using the ointment and encourage complete drying of the feet and wearingcleansocks.-Stopusingtheointmentandencouragecompletedryingofthefeetandwearingclean socks.Rationale: Athlete's foot (tinea pedi) is a fungal infection that afflicts the feet and causesscaliness and cracking of the skin between the toes and on the soles of the feet. Thefeet should be ventilated, dried well after bathing, and clean socks shouldbe placed onthe feet after bathing. Antifungal ointments may be prescribed, but antibiotic ointmentsarenot useful.A26-year-oldfemaleclientisadmittedtothehospitalfortreatmentofasimplegoiter,and levothyroxine sodium (Synthroid) is prescribed. Which symptoms indicate to thenursethattheprescribeddosageistoohighforthisclient?Theclientexperiencesa.Palpitationsandshortnessofbreathb.Bradycardiaand constipationc.Lethargyandlackofappetite
Page 9 of 16
2023 HESI RN Pediatrics Exit Exam Test Bank With Answers (490 Solved Questions) - Page 9 preview imaged.Musclecrampinganddry,flushedskin-PalpitationsandshortnessofbreathRationale: An overdose of thyroid preparation generally manifests symptoms of anagitatedstatesuchastremors,palpitations,shortnessofbreath,tachycardia,increasedappetite,agitation, sweatinganddiarrhea.A client with a history of heart failure presents to the clinic with a nausea, vomiting,yellowvisionandpalpitations.Whichfindingismostimportantforthenursetoassesstothe client?a.Determinetheclient'sleveloforientationandcognitionb.Assessdistalpulsesandsignsofperipheraledemac.Obtainalistofmedicationstakenforcardiachistory.d. Ask the client about exposure to environmental heat.-Obtain a list of medicationstakenfor cardiachistoryRationale: The client is presenting with signs of digitalis toxicity. A list of medication,which is likely to include digoxin (Lanoxin) for heart failure, can direct furtherassessment in validating digitalis toxicity with serum labels greater than 2 mg/ml that iscontributingto client'spresenting clinicalpicture.ThehealthcareproviderprescribesanIVsolutionofisoproterenol(Isuprel)1mgin250ml of D5W at 300 mcg/hour. The nurse should program the infusion pump to deliverhowmanyml/hour?(Enter numeric valueonly.)75-75Rationale:Convertmgtomcg andusetheformula D/HxQ.300mcg/hour /1,000mcgx250ml =3/1x25 =75 ml/hourThepathophysiologicalmechanismareresponsibleforascitesrelatedtoliverfailure?(Select allthatapply)a. Bleeding that results from a decreased production of the body's clotting factorsb.Fluidshiftsfromintravasculartointerstitialareaduetodecreasedserumproteinc. Increased hydrostatic pressure in portal circulation increases fluid shifts into abdomend.Increasedcirculatingaldosteronelevelsthatincreasesodiumandwaterretentione.Decreasedabsorptionoffattyacidsintheduodenumleadingtoabdominaldistention.-b.Fluidshiftsfrom intravasculartointerstitialareaduetodecreasedserumproteinc. Increased hydrostatic pressure in portal circulation increases fluid shifts into abdomend.IncreasedcirculatingaldosteronelevelsthatincreasesodiumandwaterretentionRationale: When liver fail production of albumin is reduced. Since albumin is the primaryserum protein creating intravascular osmotic pressure, decreased serum protein allowsa fluids shift into the interstitial space. Pressure increases in the portal circulation ©when venous return from the upper GI tract cannot flow freely into sclerosed liver, whichcauseapressuregradienttofurtherIncreasefluidshiftsintotheabdomen.Afailingliver
Page 10 of 16
2023 HESI RN Pediatrics Exit Exam Test Bank With Answers (490 Solved Questions) - Page 10 preview imageineffectivelyinactivatessteroidalhormones,suchasaldosteroneresultinginsodiumandwater retention.Thenurseisauscultatingaclient'sheartsounds.Whichdescriptionshouldthenurseuse to document this sound? (Please listen to the audio first to select the option thatapplies)a.S1S2b.S1S2S3c.Murmurd.Pericardialfrictionrub.-MurmurRationale:Amurmurisauscultatedasaswishing soundthatisassociatedwiththeblood turbulence created by the heart or valvular defect. B is associate with HeartFailure.Thehealthcareproviderprescribesceltazidime(Fortax)35mgevery8hoursIMforaninfant. The 500 mg vial is labeled with the instruction to add 5.3 ml diluent to provide aconcentration of 100 mg/ml. How many ml should the nurse administered for eachdose?(Enternumericvalueonly.Ifroundingisrequired,roundtothenearesttenth.0.4-0.4rationale:35mg/100mgx1=0.35=0.4mlThe nurse notes that a client has been receiving hydromorphone (Dilaudid) every sixhoursforfourdays.Whatassessmentismostimportantforthenursetocomplete?a. Auscultate the client's bowel soundsb.Observeforedemaaroundtheanklesc.Measuretheclient'scapillaryglucose leveld. Count the apical and radial pulses simultaneously-Auscultate the client's bowelsoundsRationale: hydromorphone is a potent opioid analgesic that slows peristalsis andfrequentlycausesconstipation,soitismostimportanttoAuscultatetheclient'sbowelsoundsA female client is admitted with end stage pulmonary disease is alert, oriented, andcomplaining of shortness of breath. The client tells the nurse that she wants "no heroicmeasures" taken if she stops breathing, and she asks the nurse to document this in hermedicalrecord.Whataction should thenurse implement?Ask the client to discuss "do not resuscitate" with her healthcare provider-Ask theclienttodiscuss"donot resuscitate"withherhealthcareprovider
Page 11 of 16
2023 HESI RN Pediatrics Exit Exam Test Bank With Answers (490 Solved Questions) - Page 11 preview imageA client is receiving a full strength continuous enteral tube feeding at 50 ml/hour andhasdevelopeddiarrhea.Theclienthasanewprescriptiontochangethefeedingtohalfstrength.What interventionshould the nurseimplement?a. Add equal amounts of water and feeding to a feeding bag and infuse at 50ml/hourb. Continue the full strength feeding after decreasing the rate of infusion to 25 ml/hr.c. Maintain the present feeding until diarrhea subsides and the begin the next newprescription.d.Withholdanyfurtherfeedinguntilclarifyingtheprescriptionwithhealthcareprovides.-Addequalamountsofwaterandfeedingtoafeedingbagandinfuseat50ml/hourRationale:Dilutingtheformulacanhelpalleviatethediarrhea.Diarrheacanoccurasacomplication of enteral tube feeding and can be due to a variety of causes includinghyperosmolarformula.A female client reports that her hair is becoming coarse and breaking off, that the outerpart of her eyebrows have disappeared, and that her eyes are all puffy. Which follow-upquestionisbestfor thenurse to ask?a. "Is there a history of female baldness in your family?"b."Areyouunderanyunusualstressathomeorwork?"c."Do youwork withhazardous chemicals?"d. "Have you noticed any changes in your fingernails?"-Have you noticed any changesinyour fingernails?Rationale:ThepatternofreportedmanifestationsissuggestiveofhypothyroidismAfterathirdhospitalization6monthsago,aclientisadmittedtothehospitalwith ascitesand malnutrition. The client is drowsy but responding to verbal stimuli and reportsrecently spitting up blood. What assessment finding warrants immediate intervention bythenurse?a. Bruises on armsand legsb. Round and tight abdomenc.Pittingedemainlowerlegsd.Capillaryrefill of8 seconds-Capillaryrefill of8secondsRationale:Theclientisbleedingandhypovolemiais likely.Capillaryrefillisgreaterthan3to5seconds indicatespoorperfusion andrequiresimmediateattentionAfter the nurse witnesses a preoperative client sign the surgical consent form, the nursesigns the form as a witness. What are the legal implications of the nurse's signature ontheclient's surgical consentform? (Selectallthatapply)a. The client voluntarily grants permission for the procedure to be doneb.Thesurgeonhasexplainedtotheclientwhythesurgeryisnecessary.
Page 12 of 16
2023 HESI RN Pediatrics Exit Exam Test Bank With Answers (490 Solved Questions) - Page 12 preview imagec. The client is competent to sign the consent without impairment of judgmentd.Theclientunderstandstherisksandbenefitsassociatedwiththeproceduree. After considering alternatives to surgery, the client elects to have the procedure.-a.Theclientvoluntarilygrants permissionforthe proceduretobedonec.Theclientiscompetenttosigntheconsentwithoutimpairmentofjudgmentd.TheclientunderstandstherisksandbenefitsassociatedwiththeprocedureRationale:Informconsentisrequiredforanyinvasiveprocedure.Thenurse'ssignatureas a witness to the client's signature on surgical consent indicates that the clientvoluntary gives consent for the scheduled procedure. C is competent to give consent,andDandunderstandthe riskandbenefitsoftheprocedure.Followingsurgery,amaleclientwithantisocialpersonalitydisorderfrequentlyrequeststhat a specific nurse be assigned to his care and is belligerent when another nurse isassigned.What actionshouldthechargenurse implement?a. Ask the client to explain why he constantly request the nurseb.Encouragetheclienttoverbalizehisfeelingsaboutthenursec.Reassuretheclientthathis requestwillbemetwheneverpossible.d. Advise the client that assignments are not based on client requests-Advise the clientthatassignmentsare not basedonclients requestsRationale:Thosewithantisocialpersonalitydisordersaremanipulativeinordertomeettheir own needs. The charge nurse must set limits on this behavior. The client'ssuperficial charm and emotional maturity prevent effective therapeutic communicationand (A and B) will be used to the client's advantage. C encourage further manipulativebehavior.A client with cervical cancer is hospitalized for insertion of a sealed internal cervicalradiationimplant.Whileprovidingcare,thenursefindstheradiationimplantinthebed.Whataction shouldthenurse take?a.Calltheradiologydepartmentb.Reinserttheimplantinto thevaginac.Applydoubleglovestoretrievetheimplantfordisposal.d.Place the implant in a lead container using long-handled forceps-Place the implantina lead containerusing long-handled forcepsRationale: Solidor sealed radiation sources, such as Cesium which is removed aftertreatment, are inserted into an applicator or cervical implant to emit continuous, lowenergy radiation for adjacent tumor tissues. If the radiation source or the applicatorbecomedislodgedlong-handledforcepsshouldbeusedtoretrievetheradiationimplant
Page 13 of 16
2023 HESI RN Pediatrics Exit Exam Test Bank With Answers (490 Solved Questions) - Page 13 preview imagetopreventinjuryduetodirecthandling.Theapplicatoristhenplacedintheleadcontainer.Theclientwithwhichtypeofwoundismostlikelytoneedimmediateinterventionbythenurse?a. Lacerationb. Abrasionc.Contusiond.Ulceration-LacerationRationale:Alacerationisawoundthatisproducedbythetearingofsoftbodytissue.This type of wound is often irregular and jagged. A laceration wound is oftencontaminatedwithbacteriaanddebrisfrom whateverobjectcausedthecutThenurseisplanningcareforaclientadmittedwithadiagnosisofpheochromocytoma.Whichinterventionhasthehighestpriority forinclusioninthisclient's planofcare?a.Recordurineoutputeveryhourb.Monitorbloodpressurefrequentlyc.Evaluateneurologicalstatusd.Maintainseizureprecautions-MonitorbloodpressurefrequentlyRationale: A pheochromocytoma is a rare, catecholamine-secreting tumor that mayprecipitatelife-threateninghypertensionWhencaringforaclientwhohas acuterespiratorydistresssyndrome(ARDS),thenurseelevatestheheadofthebed30degrees.Whatisthereasonforthisintervention?a.Toreduceabdominalpressureonthediaphragmb.topromoteretractionoftheintercostalaccessorymuscleofrespirationc.topromotebronchodilationandeffectiveairwayclearanced. to decrease pressure on the medullary center which stimulates breathing-To reduceabdominalpressure onthediaphragmRationale: a semi-sitting position is the best position for matching ventilation andperfusion and for decreasing abdominal pressure on the diaphragm, so that the clientcanmaximize breathingWhenassessingamildlyobese35-year-oldfemaleclient,thenurseisunabletolocatethegallbladderwhenpalpatingbelowthelivermarginatthelateralborderoftherectusabdominal muscle. What is the most likely explanation for failure to locate thegallbladderbypalpation?a.Theclient istooobeseb.Palpatinginthewrongabdominalquadrant
Page 14 of 16
2023 HESI RN Pediatrics Exit Exam Test Bank With Answers (490 Solved Questions) - Page 14 preview imagec.Thegallbladderisnormald.Deeperpalpationtechniqueisneeded-ThegallbladderisnormalRationale:anormalhealthygallbladderisnotpalpableA woman with an anxiety disorder calls her obstetrician's office and tells the nurse ofincreased anxiety since the normal vaginal delivery of her son three weeks ago. Sinceshe is breastfeeding, she stopped taking her antianxiety medications, but thinks shemayneedtostarttakingthemagainbecauseofherincreasedanxiety.Whatresponseisbest for the nurse toprovidethis woman?a.Describethetransmissionofdrugsto theinfantthroughbreastmilkb.Encouragehertousestressrelievingalternatives,suchasdeepbreathingexercisesc.Informherthatsomeantianxietymedicationsaresafeto takewhilebreastfeedingd. Explain that anxiety is a normal response for the mother of a 3-week-old.-Inform herthatsomeantianxietymedicationsaresafetotake whilebreastfeedingRationale: There are several antianxiety medications that are not contraindicated forbreastfeeding mothers. The woman is apparently aware that drugs can be transmittedthrough breast milk, so A is not helpful. C might be helpful, but the client's historysuggestthatnonpharmacologicalmethodsofanxietymanagementdonotproducethebestoutcome. (D)themother'shistory placesheratriskfor severeanxiety.Anoldermaleclientwith ahistoryoftype1diabeteshasnotfeltwellthepastfewdaysand arrives at the clinic with abdominal cramping and vomiting. He is lethargic,moderately, confused, and cannot remember when he took his last dose of insulin orate last.What actionshouldthenurse implementfirst?a.obtainaserumpotassiumlevelb.administertheclient'susualdoseofinsulinc.assesspupillary response tolightd. Start an intravenous (IV) infusion of normal saline-Start an intravenous (IV) infusionofnormal salineRationale:thenurseshouldfirststartanintravenousinfusionofnormalsalinetoreplacethe fluids and electrolytes because the client has been vomiting, and it is unclear whenhe last ate or took insulin. The symptoms of confusion, lethargy, vomiting, andabdominal cramping are all suggestiveof hyperglycemia, which also contributes todiuresisand fluid electrolyte imbalance.Aclientwhoreceivedmultipleantihypertensivemedicationsexperiencessyncopedueto a drop in blood pressure to 70/40. What is the rationale for the nurse's decisiontoholdthe client'sscheduledantihypertensivemedication?a.Increasedurinaryclearanceofthemultiplemedicationshasproduceddiuresisandlowered thebloodpressure
Page 15 of 16
2023 HESI RN Pediatrics Exit Exam Test Bank With Answers (490 Solved Questions) - Page 15 preview imageb.Theantagonisticinteractionamongthevariousbloodpressuremedicationshasreducedtheireffectivenessc.Theadditiveeffectofmultiplemedicationshascausedthebloodpressuretodroptoolow.d.Thesynergisticeffectofthemultiplemedicationshasresultedindrugtoxicityandresulting hypotension.-The additive effect of multiple medications has caused thebloodpressuretodroptoo lowRationale:Whenmedicationwithasimilaractionareadministered,anadditiveeffectoccurs that is the sum of the effects of each of the medication. In this case, severalmedications that all lower the blood pressure, when administer together, resulted inhypotension.Whichclientisatthegreatestriskfordeveloping delirium?a.Anadultclientwhocannotsleepduetoconstantpain.b.an older clientwhoattempted1monthagoc.ayoungadultwhotakesantipsychoticmedicationstwiceadayd. a middle-aged woman who uses a tank for supplemental oxygen-An adult client whocannotsleep duetoconstant pain.Rationale: Client who are in constant pain ad have difficulty sleeping or resting are athigh risk for delirium. Supplemental oxygen may cause confusion. B is takingmedicationsoisnotathighrisk ofdelirium.Which intervention should the nurse include in a long-term plan of care for a client withChronicObstructive Pulmonary Disease (COPD)?a.Reducerisksfactorsforinfectionb.Administerhighflowoxygenduringsleepc.Limitfluidintaketoreducesecretionsd. Use diaphragmatic breathing to achieve better exhalation-Reduce risks factors forinfectionRationale: Interventions aimed at reducing the risk factors of infections should beincludedintheplanofcareCOPDclientareatparticularriskforrespiratoryinfection.Preventionandearly detectionof infectionsarenecessary.Whichlocationshouldthenursechooseasthebestforbeginningascreeningprogramforhypothyroidism?a.Abusinessandprofessionalwomen'sgroup.b.AnAfrican-Americanseniorcitizenscenter
Page 16 of 16
2023 HESI RN Pediatrics Exit Exam Test Bank With Answers (490 Solved Questions) - Page 16 preview imagec.AdaycarecenterinaHispanicneighborhoodd. An after-school center for Native-American teens-A business and professionalwomen'sgroupRationale: The population at highest risk is A so this is the group that would benefit themostforascreeningprogram ofhypothyroidism andoccurs between35and60yearsofageandis most common infemales.Afemaleclienthasbeentakingahighdoseofprednisone,acorticosteroid,forseveralmonths.Afterstoppingthemedicationabruptly,theclientreportsfeeling"verytired".Whichnursinginterventionismostimportantforthenursetoimplement?a.Measurevitalsignsb.Auscultatebreathsoundsc.Palpatetheabdomend.Observetheskinforbruising-MeasurevitalsignsRationale:Abruptwithdrawalofanexogenouscorticosteroidscanprecipitateadrenalinsufficiency and hypoglycemia, hypokalemia, and circulatory collapse can occur. Ismostimportant forthenurseto assessvital signto impendingshock.A male client reports the onset of numbness and tingling in his fingers and around hismouth. Which lab is important for the nurse to review before contacting the health careprovider?a.capillaryglucoseb.urinespecificgravityc.Serumcalciumd.whitebloodcellcount-Serum calciumRationale:Numbnessandtinglingofthefingersandaroundthemouth,alongwithmusclecramps are signs ofhypocalcemiaWhatexplanationisbestforthenursetoprovideaclientwhoasksthepurposeofusingthelog-rollingtechnique for turning?a.workingtogethercandecreasetheriskforbackinjuryb.Thetechniqueisintendedtomaintainstraightspinalalignment.c.Using twoor threepeopleincreases clientsafety.d. turning instead of pulling reduces the likelihood of skin damage-The technique isintendedtomaintainstraight spinalalignment.Rationale: The main rationale for use of the long-rolling technique is to maintain theclient'sspine straight alignment.
Preview Mode

This document has 216 pages. Sign in to access the full document!

Study Now!

X-Copilot AI
Unlimited Access
Secure Payment
Instant Access
24/7 Support
Document Chat

Document Details

Subject
Health Education Systems, Inc.

Related Documents

View all
Certification Guides

Nursing School Entrance Exams: HESI A2 / NLN PAX-RN / PSB-RN / RNEE / TEAS, 6th Edition (2020)

5.0
00
Past Exams

HESI Evolve Leadership/Management Practice Exam with Answers (114 Solved Questions)

4.8
00
Past Exams

HESI Comprehensive Medical Surgical Exit Exam with Answers (839 Solved Questions)

4.7
00
Past Exams

2024 HESI Mental Health Actual Exam With Answers (151 Solved Questions)

4.0
00
Past Exams

2023-2024 HESI RN Pharmacology Actual Exam With Answers (180 Solved Questions)

4.1
00
Past Exams

HESI Pharmacology Practice Exam With Answers (102 Solved Questions)

4.7
00
Past Exams

HESI Mental Health Exit Exam With Answers (58 Solved Questions)

4.1
00
Past Exams

HESI Fundamentals Proctored Exam With Answers (6 Solved Questions)

4.7
00
Past Exams

2023 HESI Grammer A2 Exam With Answers (41 Solved Questions)

4.6
00
Past Exams

HESI Grammar A2 Exam Testbank With Answers (50 Solved Questions)

4.6
00
2023 HESI RN Pediatrics Exit Exam Test Bank With Answers (490 Solved Questions) - Past Exams | Health Education Systems, Inc.